Attachment 6. COSR.pdf

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Contract Oversight Surveillance Report

1. Contract # / Service

2. Contract Location

3. Contract Performance Period

4. Evaluation Period

5. Contract Service Provider

6. Method(s) of Surveillance (check all that apply for this surveillance period) Requirement Surveillance Comments

Surveillance Methods Described -

- Direct Observation is the visual examination of processes and procedures by an evaluator who is physically present and watching individuals actually performing the work to determine whether the processes conform to the requirements.

- Random Sampling is correctly performed by selecting a statistically significant number of samples from a lot where all members of the lot have the same chance of being selected. Random Sampling is used to reduce the time and effort of validating conformance to requirements when a definable lot of significant size exists.

- 100% Inspection method evaluates all outputs of a particular requirement. Every item in a lot is evaluated for all or some of the characteristics in the specification. (Recommend if Lot Size is 25 or less)

- Validated Customer Complaints are customer complaints that prove to be valid upon subsequent investigation. They can be used as a trigger for conducting surveillances, and are included as a part of the surveillance report. When a valid complaint is received and included in a surveillance activity, strongly consider scheduling targeted follow up surveillance to ensure the problem has been corrected. These can prompt corrective actions, preventative action plans, and performance improvement plans.

7. Overall Surveillance Evaluation

8. Additional Comments / Notes to the Contracting Officer (Either positive or negative)

9. COR/TPOC Certification - I certify that the supplies or services provided by the Service Provider under the terms and conditions of this contract, have been received and accepted unless otherwise noted on this surveillance report.

Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments Requirement Surveillance Comments 10.0.2.20120224.1.869952.867557

Requirement: 6. Did the COR advise the contract manager in person when discrepancies occurred and request a corrective action, in accordance with Section 1.10 in the J.1 Performance Work Statement and/or applicable SOP/guidance?

Requirement: 7. Did the Contractor notify the COR at least 72 hours before the preventative maintenance services start to allow the COR to accept or reject based on mission critical operations at the time, in accordance with Section 4.1 in the J.1 Performance Work Statement and/or applicable SOP/guidance?

Requirement: